Roller coaster ride!

When I began considering weight loss surgery (wls), I searched high and low for blogs, vlogs, forums, etc about the pre-op journeys. I didn't have much luck, so decided to start my own, in hopes to help others (one day) on what to expect along the way. Now I know why I didn't have much luck...the process is a slow and sucky one! It is such an emotional rollercoaster filled with uncertainties!

I had a few more psych visits since I last posted. She has been really helpful as we have worked our way through the Beck Diet. It is a 30 day behavior modification program/book. It's awesome! I have lost 14.5 pounds since I began my wls trip!

I visited the surgeon my doctor recommended. He was knowledgeable and friendly. It wasn't as earth shattering as I anticipated...just another doctor visit. I "picked" my surgery...gastric bypass. I can always change, but needed a definite procedure to start the paperwork process.

I didn't have a ton of questions, but wondered why it wasn't standard to remove gallbladders as a common side affect is gallstones. He explained that they would if it was necessary, but it is always best to do the least invasive surgery to promote healing. They would do an ultrasound beforehand to see if it is needed. He also snuck in "gallbladders fear me" which left me laughing for days!

The other question I had was about the pre-op diet. I was told that or the 2 weeks before surgery to use whatever kind of diet I chose to lose as much weight as possible. No need to go on full liquids, unless I choose to. Um...hell no! I won't be doing that if I don't HAVE to...I'll get enough of the liquid diet post-op!

The insurance coordinator was gone at that time, so she called me yesterday. I am nervous that everything won't come together and that my doctor supervised diet and exercise isn't what the insurance needs/wants. My doctor has done this before, so I should be at peace, but I am a nervous Nelly! This is alot of work and money to be spent on a denial!

While I should be thrilled about my progress to this point (and I kinda am) it is overshadowed by doubt and what if's.

• What if I "waste" time and money and no surgery? 
• What if I should just use a dietician and/or psychologist and try one more time? 
• What if I am denied and don't lose any weight? What if I am denied and have to battle for a few more years to get approved? 
• What if everything goes as planned AND I still don't lose weight?

Ya...like I said, I'm a worrier! Hmpf!

WOOHOO!!

That's right...10 POUNDS LOST!

It's been a busy week of appts for me! On Tuesday, I had another psych visit. Wow...that was fun to have her stroke my ego. She was happy with my progress and helped me set some goals to get back on track with exercise. (After a week of sick kiddos, I fell off the exercise bandwagon. HARD!) I have 2 standing appointments and she told me to wait and not schedule anymore just yet. honestly, I like the accountability that the psych visits have offered me.

Then, there is the other end of the spectrum...the dietician. My first (and only???) visit was today. I am NOT impressed! She was unorganized, spoke down at me, and didn't provide realistic guidelines. She had some advice on WHAT to do, but gave no suggestions on HOW to do it/techniques/plan/etc. She noted that I had successfully lost weight on a 1700 calorie diet, but suggested that I follow a 1200 calorie diet about every other day. Whatever lady!

She thinks that by following a 1200 calorie diet, it would show that I could truly be disciplined after surgery. So, I can use my "willpower" to follow a post-op diet WITHOUT the restriction?! Hello! If I could follow a 1200 diet long-term, I wouldn't need to have surgery. In addition, maybe you could offer some follow up care!

However, when I asked her how frequently she suggested we meet...are you ready for this....she said that she typically meets with pre-op patients once. ONCE! That is MESSED up!!

Mindful Eating

I swear, this has to be the hardest thing ever! My "Beck Diet" assignment was to be a mindful eater. To thoroughly chew each and every bite and to pause 10 seconds between bites. Seriously!?! While I know that this is important, IT IS SO HARD!

I am constantly reminding myself to "DO IT ANYWAYS!" A reminder that is suggested multiple times throughout the book.

Here's a link it you want to check the book out! The Beck Diet and The Beck Diet Workbook...you only need one or the other...I bought both.

Reschedule, Reschedule, Reschedule

Man...that's annoying!

I had an appointment scheduled to see the dietician on Monday at 9:30...got a call a few moments before I was scheduled to head out the door. The dietician had an emergency and needed to reschedule until Tues...same time. So....off to work I went. Upon returning home, there was another message asking to reschedule to Wed at 8:30. GRRRR...kiddos don't have school, so I had to make arrangements for someone to watch them.

WEEELLLLL....as luck would have it, Wednesday morning comes along (today) and my lovely daughter awoke with a fever. The dietician, of course, has a "crazy" schedule and won't be at my clinic for two weeks.

I had a little panic attack because one of the insurance requirements is 6 consecutive months of weights. That would leave a gap in MONTH TWO. While making an appt for my daughter, I had them check and the psych did indeed enter a weight at our last visit, so...all is well again.

My hubby even commented how long this process has been and wished (for me) that this wasn't so difficult. It hasn't been difficult, per say. Though, it is WAY more appts then I'm used to, paired with mistaken appts and rescheduling.

Another "first"

This week was my first trip to the psychologist! It really wasn't as bad as I envisioned. For this visit, it was basically taking an inventory if I exhibited signs of depression, mania, OCD, anxiety, paranoia, phobias, substance abuse, etc. She told me nothing that I didn't already know...I worry too much and have an all or nothing mentality. I think I actually USED those exact phrases myself in our visit! LOL!

She suggested 2 programs for our visits. The first one is called the LEARN program. A recommended curriculum by some major hospitals in our area. I am going to call and see if MY surgeon requires this specific program. It combines nutrition and psychological topics.

The other program she recommended was called The Beck Diet. I instantly fell in love with this approach to using a psychological approach to weight loss. Let's face it, I KNOW about nutrition...it's my head that needs to be able to apply my knowledge. I look forward to figuring all that "stuff" out!

Oh...I have had an awesome eating and exercising week. Since my first visit,a month ago, I think I have lost 5.5 pounds! YAY ME! I especially find that AMAZING in light of the floods that struck my town causing a stressful, expensive and emotionally draining time!

A jumble of updates...and more visits!

I am proud to report that all by blood work came back good! I must admit that I am amazed!

I had my first EVER psychologist appointment on Monday. It was AWESOME! Within the first 2 minutes, the Dr. asked if I was there for a gastric bypass eval. I said I was exploring my weight loss surgery options and that, in the end, I would like an eval. She apologized, but said she couldn't help me.

She was in the process of becoming qualified or using the specific assessment tool that they used, but at this time was not qualified. All in all, I appreciated her honesty (and the fact that she assured me that I wouldn't be charged for the visit.) The receptionist had misread the instructions and set up an appointment with the wrong person.

She was gracious and helped me set up appointments with someone whom WAS able to do the specific type of assessment that I needed. As I was on the phone with the "qualified" psychologist's receptionist, she shared that she was 3 years gastric bypass post op. She LOVED sharing and said she would do it again in a New York minute. She had lost 100 pounds and was off her diabetes meds in 2 months...a very happy patient.

I have an appointment with the new psychologist next week. Should be interesting!

New POA???

I met with my family doctor today. Being from a SMALL town, this amazing gal does it all! She has seen me threw all of my pregnancies, delivered my babies, takes care of my sniffles, etc.

When I began this journey, she was the first person I set up an appt with. However, being the impatient person I am, I went ahead and scheduled my visits with the surgeon.

We did our annual (well....a few years MORE than annual for me) visit and chit chatted the whole time. I told her that I had went to an initial visit with the surgeon. She looked at me with a solemn face and shook her head "no".

"Really?" I  said.

"No."

Ah, man!!! My plan shot out of the water???

I genuinely trust my doctor. She has been my doc for over 11 years. She looks out for the best interest of my family. She has also referred my family to the best doctors when they have needed specialized care (and trust me.....we've needed it!)


She was concerned about a number of things including experience, skill, etc. She has worked with Dr. L AND has seen his patients post-op (for other laproscopic procedures.) She hasn't been impressed. :(

However, she did have advice. She has worked with another surgeon with tons more experience, a good bedside manner, etc. While he is a much farther drive away, I would only have to make a couple trips out to see him. She talked to me about the plan of getting the required visits in and shared experiences of other patients. She said she could set something up for me to talk to those whom have gone through the process themselves.

One thing she mentioned was that all of her patients that started out wanted to get a lapband had ended up getting a gastric bypass. WHAT? I told her that I didn't think I could live that lifestyle. Honestly, I didn't have a WHOLE lot of points to back up my argument, but a gastric bypass seemed so.....um, permanent! I worried about rerouting my intestines and losing weight so quickly. She assured me that the lapband truly is permanent to be effective. One would have to have another procedure to remove it or to fix it if a problem would occur. While I never hoped to have those issues, in my head, I kinda think that it gave me the option to try something else IF it didn't work. Really, I don't have options! I HAVE to make whatever decision I make work! This IS permanent!

I shared my concern about insurance and she looked at my records and I had been there within 2 years and by bmi was 40 then. (yay!?!) Just a few days before my visit, I came in to get a tetanus shot and the doc put me on high blood pressure meds. (YUCK!) She said that this would also be beneficial in the approval process.

Before I left, we set up a plan for visits within the next few months. I set up a lab appointment for tomorrow and will get a call once the other visits have been set up.

Met the surgeon....

no emergency surgeries today!

I must say that he (Dr. L) cracks me up! He was open, honest, "real"....and he swore! I know that might bug some people. However, to me, it was honest....and if we want to be truthful here....I swear too ;) way more than I should!

I met in a group with Dr. L and the same 2 ladies (potential lapbanders) from last week. I believe this is the only time that we will meet together as a group.  At the last visit we were encouraged to research, research, research. The first thing Dr. L said this time was to "forget everything you have read until this point."   WTF? The HOURS I have spent scouring the internet for any piece of info are to be completely thrown out? No...not in that sense. He wanted us to not have the impression that is process is just about losing weight. He assured us that ANY diet/tool/surgery may HELP us lose weight, but the "thing" that truly determined our success was US! Of course, it makes perfect sense! He wanted to encourage us to "get our stuff figured out" upstairs.

I think that is practical advice. I left feeling encouraged and excited for the possibilities!

First Hurdle! UGH!

One (of the many things) I worry about in this process is being approved my insurance. One of the requirements from my insurance is that presence of severe obesity that has persisted for at least the last 2 years (24 months). While I know that I have been, I worried that I wouldn't have proof. There have been periods of time where my BMI may have been too low to qualify, but those instances were BRIEF.

Well, today I got a letter from the clinic stating that they couldn't release my medical records from the last 2 years because there wasn't ANY. WHAT? NOT ANY?

Of course, I call the gal that handles medical records is GONE...until Monday.

Panic mode strikes!

First Lap Band Pre-op Appointment

Today was my first appointment! YAY! When I scheduled my appointment, the receptionist mentioned that it would be a 2 hour appointment as I would meet with the surgeon, "Dr. L",  and the dietitian. When I arrived, there waiting room seemed "busy"...not what one would expect for a small town private practice. That made me instantly think the doctor was running behind...ugh!  After about a 30 minute wait, the man I recognized from website pictures walks into the lobby ON HIS WAY OUT THE DOOR! He pauses to apologize and said that a patient at the hospital (across the street) was having complications and they couldn't get a hold of this patient's doctor. So...he was going over there to check it out. He paused, but it was obvious that he knew that this was serious and he may not return.

The clinic staff scrambled and the came up with a plan. A nurse took my vitals and sent me back to the waiting room. I was one of three potential lap band patients. We were each waiting for our first visit. In light of the recent emergency, it was decided that we would do a group session to get the typical "first" appointment information. We meet together with the dietitian and she went over the basics.

The dietitian shared the "Recommended Dietary Changes Before Surgery." The following are the recommended changes.

• Do not skip breakfast-eat three meals a day
• Have a good source of protein in the morning, such as an egg, 1 oz. cheese, yogurt (100 cals or less), lean deli meat, etc
• Decrease portion size
• Make better choices when eating out (low fat/low cal)
• Increase intake of fruits and vegetables. Try to eat 2 different fruits each day AND 2 different vegetables each day. Vegetables CAN NOT be corn, peas, or potatoes
• Increase activity (walking/swimming/videos)
• Decrease intake of deserts/candy/sweets/baked goods/ice cream
• Decrease fat in diet (choose low fat more often and avoid fried foods)
• Decrease caffeinated and/or carbonated beverages, and calorie-containing beverages
• Drink at least 64 oz of water per day. Any caffeine-free, calorie-free, non carbonated beverages can count towards daily water intake
• Decrease alcohol consumption or completely avoid
• Begin an adult, chewable multivitamin every other day, such as Centrum or Centrum Silver. Make sure the multivitamin contains 25-30 different vitamins and minerals. Bariatric Advantage is a good place to start (online)
• Avoid snacking or eating after 7pm (or 3 hours before your longest sleeping period)
• Practice CHEWING foods thoroughly. Slow down rate of eating.
• Practice SIPPING beverages-no "chugging" or gulping
• Practice NO LIQUIDS 30 MINUTES BEFORE, DURING OR AFTER MEALS.
• Keep food records and return

The dietitian said that if Dr. L was there, he would say absolutely no regular pop from this day forward. Phew...glad I switched to diet YEARS ago! The "rules" we would focus on now would be

1. Eat breakfast and include a protein.
2. Begin documenting in the food journal 3-4 days a week.
3. Eliminate beverages with calories.

That seems very doable!

This was my first ever experience with a dietitian and, I have to admit, she wasn't half as scary as I envisioned! She even said things like "Dr. L and I encourage treat days" and "you will never hear me say 'only buy nonfat products'" and "you can have a cup or 2 of coffee, but I wouldn't recommend a pot."

The appointment did indeed take over 2 hours, but I only spent about 25 minutes of that "in" the appointment! I will see Dr. L next Tuesday and then back in a month for the next visit.

I had been such a ball of nerves when I began researching and making the initial appointments. Ever since that initial call was made, I have been at peace. It's a nice feeling! One question I did ask was about the required psychological eval. I wondered if I should make an appt soon, or if that should be done later in the process. It was recommended to go ahead and make the appointment now as it may take some time to get in. Good to know!

My only concern at this point is that I have documented weights (on clinic records) with a BMI above 40 for the past 2 years or 35 with co-morbidities. I am pretty sure that I have high blood pressure and have for the last 2 years. HOWEVER, I also don't really go to the doctor unless I am sick...and I rarely get sick!

Oh...another tidbit of info that I was excited to hear was that Dr. L can, if you are a good candidate, do the procedure with ONE incision and not the typical 4 or 5! Cool!

Planning the Journey

I remember the day all too clearly...August 7, 2010. My friend, Britta and I were having a girls weekend away with friends whom we typically see annually. It's always a fun weekend, but a time when I always want to look my best (but never really do.) There are always lots of pictures taken.Let me tell you, I am ALWAYS the one taking pictures, not IN them! Obviously, I am never really happy with how I look photos!

Today, was no different than any other day in that we had been discussing our frustrations with weight. We had just pulled into our parking space outside of Barnes and Noble. I looked over at Britta, and said "I think I want to get a lap band." She nearly interrupted me and said "you should." I looked at her...surprised. She instantly tried to soften her words in an effort not to offend me.  I didn't take offense to the comment...I was surprised that she was encouraging me! No one had ever given me that kind of encouragement. It was a simple statement. She was merely saying that if I felt that choosing gastric banding would be helpful that I should look into it. In no way would she realize how those 2 small words would possibly change my life.

In all honesty, I expected that the conversation would end there and the subject would quickly change, so I quickly began to gather my things to head for the store. I looked at her and tears began to fill up my eyes. She reiterated "really, if you think that would help you and that is what you want, I think you should." I told her how embarrassed I was and she was totally understanding.

As soon as I got home, I immediately began researching weight loss surgery. I watched HOURS and HOURS of youtube videos, read loads of blogs, scoured my insurance information regarding coverage, and even watched an actual surgery online. However, I still didn't really know where to start.

It took me about 3 weeks before I decided the first step was to call my primary care physician. They couldn't get me in for over a month...A MONTH! Those whom know ANYTHING about me is to know that I am not one to wait around once I get an idea in my head. I contacted my doctor and she assured me it was a slow process. Initially, I kind of felt like throwing in the towel. I knew the process was long.  However, I quickly came to the realization that a month (or even the 3-6 month period prior to surgery) would be such a small portion of my much longer journey on the road to a healthy life.

Still reluctant to wait a month to see my doctor, I asked the one and only lapband patient I know what she recommended for "the first step." She suggested that I contact my insurance to see if I needed a referral. Regardless, I should make the call and set up an appointment with Dr. Lee. My referral from my primary doctor would "catch up"insurance wise.

It took me 2 days to get up the nerve to call my insurance company (Aetna). Mind you, this entire month, lap band research/questions/anxiety had been consuming EVERY moment of my life. It was all I could think about. The insurance gal was very helpful and answered alot of questions and confirmed info I had been checking (and double checking) regarding my policy. I did NOT need a referral. PHEW!

I was on such a high after that phone call! I immediately messaged Britta and she encouraged me to call the lapband doctor's office while I still had the courage.I felt sick to my stomach! I was a ball of nerves! I picked up the phone and set up an appointment for September 13th. It was about a week and a half away. Surprisingly, after the phone call was made, my nerves have really calmed down and the process hasn't been as consuming. My first appointment is now a mere hour and a half away. I am meeting with the surgeon and a nutritionist and was told to anticipate a 2 hour appointment. I am excited to begin my journey down the road to healthier me!